对在职类风湿关节炎患者的工作不稳定、功能损害和疾病活动情况的一项检查。

An examination of work instability, functional impairment, and disease activity in employed patients with rheumatoid arthritis.

作者信息

Macedo Alyssa, Oakley Stephen, Gullick Nicola, Kirkham Bruce

机构信息

Guy's and St. Thomas' NHS Foundation Trust, London, UK.

出版信息

J Rheumatol. 2009 Feb;36(2):225-30. doi: 10.3899/jrheum.071001. Epub 2009 Jan 22.

DOI:10.3899/jrheum.071001

PMID:19208557

Abstract

OBJECTIVE

To evaluate the relationship between the Disease Activity Score 28-joint count (DAS28), Health Assessment Questionnaire (HAQ), and Rheumatoid Arthritis-Work Instability Scale (RAWIS); and to define thresholds for clinical assessments associated with moderate to high RA-WIS.

METHODS

Employed patients with RA were evaluated using DAS28, HAQ, and RA-WIS during routine clinics. Relationships between these assessments were evaluated by simple correlation. Multiple linear regression modeling was performed using RA-WIS as an outcome variable and HAQ, DAS28, age, sex, occupation, and disease duration as input variables. Receiver-operating characteristic curves were then formulated to determine optimal DAS28, and HAQ cutoff points for RA-WIS >or= 10, along with the odds ratio (OR).

RESULTS

Ninety patients with RA completed the RA-WIS, which was moderately correlated with DAS28 (r =0.53) and HAQ (r = 0.66). Fifty-four percent of RA-WIS was explained by DAS28 (p = 0.002), HAQ (p = 0.001), and sex (p = 0.04). A DAS28 of 3.81 and HAQ of 0.55 were clinically important thresholds. High DAS28 and HAQ were associated with high RA-WIS (OR(DAS) 14.17, OR(HAQ) 25.13, OR(DAS+HAQ) 29.9).

CONCLUSION

Functional impairment and disease activity significantly and independently contributed to patient-perceived work instability risk.

摘要

目的

评估28个关节计数的疾病活动评分（DAS28）、健康评估问卷（HAQ）和类风湿关节炎 - 工作不稳定性量表（RAWIS）之间的关系；并确定与中度至高度类风湿关节炎工作不稳定性相关的临床评估阈值。

方法

在常规门诊期间，使用DAS28、HAQ和RAWIS对类风湿关节炎患者进行评估。通过简单相关性评估这些评估之间的关系。以RAWIS作为结果变量，HAQ、DAS28、年龄、性别、职业和病程作为输入变量进行多元线性回归建模。然后绘制受试者工作特征曲线，以确定RAWIS≥10时的最佳DAS28和HAQ截断点，以及优势比（OR）。

结果

90例类风湿关节炎患者完成了RAWIS评估，RAWIS与DAS28（r = 0.53）和HAQ（r = 0.66）中度相关。RAWIS的54%可由DAS28（p = 0.002）、HAQ（p = 0.001）和性别（p = 0.04）解释。DAS28为3.81和HAQ为0.55是具有临床意义的阈值。高DAS28和高HAQ与高RAWIS相关（OR（DAS）14.17，OR（HAQ）25.13，OR（DAS + HAQ）29.9）。